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3321. The CAHPS Ambulatory Care Improvement Guide: Are You Ready To Improve? (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/cahps/quality-improvement/improvement-guide/3-are-you-ready/cahps-ambulatory-care-guide-section-3.pdf
      May 01, 2017 - The CAHPS Ambulatory Care Improvement Guide: Are You Ready To Improve? The CAHPS Ambulatory Care Improvement Guide Practical Strategies for Improving Patient Experience Section 3: Are You Ready To Improve? Visit the AHRQ Website for the full Guide. May 2017 (updated) https://www.ahrq.gov/cahps/quality-improve…

3322. An Analysis of Nurses' Cognitive Work: A New Perspective for Understanding Medical Errors (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Potter.pdf
      January 01, 2003 - An Analysis of Nurses' Cognitive Work: A New Perspective for Understanding Medical Errors 39 An Analysis of Nurses’ Cognitive Work: A New Perspective for Understanding Medical Errors Patricia Potter, Laurie Wolf, Stuart Boxerman, Deborah Grayson, Jennifer Sledge, Clay Dunagan, Bradley Evanoff Abstract He…

3323. Can an Academic Health Care System Overcome Barriers to Clinical Guideline Implementation? (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Quinn.pdf
      January 01, 2004 - Can an Academic Health Care System Overcome Barriers to Clinical Guideline Implementation? 291 Can an Academic Health Care System Overcome Barriers to Clinical Guideline Implementation? Debra Quinn, Mary Cooper, Lynn Chevalier, Jerry Balentine, Lawrence Kadish, Steven Walerstein, Fredric Weinbaum, Mark Ca…

3324. Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients' subsequent clinical course and outcomes (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/topics/bridging-feedback-gap.pdf
      June 21, 2021 - Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients' subsequent clinical course and outcomes VIEWPOINT Bridging the feedback gap: a sociotech…

3325. A Model-based Approach to Prioritizing Medical Safety Practices (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Marken.pdf
      January 01, 2004 - A Model-based Approach to Prioritizing Medical Safety Practices 409 A Model-based Approach to Prioritizing Medical Safety Practices Richard S. Marken Abstract This report shows how a model of skilled human performance can be used to evaluate safety practices aimed at reducing medical error when randomized tr…

3326. Identifying Barriers to the Success of a Reporting System (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Harper.pdf
      March 01, 2004 - Identifying Barriers to the Success of a Reporting System 167 Identifying Barriers to the Success of a Reporting System Michelle L. Harper, Robert L. Helmreich Abstract Spurred by a controversial report from the Institute of Medicine on the prevalence of medical error, To Err Is Human, the medical profe…

3327. Lessons in Safety Climate and Safety Practices from a California Hospital Consortium (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Singer.pdf
      April 01, 2003 - Lessons in Safety Climate and Safety Practices from a California Hospital Consortium 411 Lessons in Safety Climate and Safety Practices from a California Hospital Consortium Sara J. Singer, Kelly M. Dunham, Jennie D. Bowen, Jeffrey J. Geppert, David M. Gaba, Kathryn M. McDonald, Laurence C. Baker Abstract…

3328. The Impact of a Web-based Reporting System on the Collection of Medication Error Occurrence Data (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Rudman.pdf
      January 01, 2004 - The Impact of a Web-based Reporting System on the Collection of Medication Error Occurrence Data 195 The Impact of a Web-based Reporting System on the Collection of Medication Error Occurrence Data William J. Rudman, Jessica H. Bailey, Carol Hope, Paula Garrett, C. Andrew Brown Abstract This paper examin…

3329. Creating a Curriculum for Training Health Profession Faculty Leaders (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Mitchell.pdf
      March 31, 2004 - Creating a Curriculum for Training Health Profession Faculty Leaders 299 Creating a Curriculum for Training Health Profession Faculty Leaders Pamela H. Mitchell, Lynne S. Robins, Douglas Schaad Abstract Objectives: An interprofessional, collaborative group of educators, patient safety officers, and Federal …

3330. VHA’s National Falls Collaborative and Prevention Programs (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Stalhandske2_70.pdf
      March 01, 2006 - VHA’s National Falls Collaborative and Prevention Programs VHA’s National Falls Collaborative and Prevention Programs Erik Stalhandske, MPP, MHSA; Peter Mills, PhD; Pat Quigley, PhD, ARNP, CRRN, FAAN; Julia Neily, MS, MPH; James P. Bagian, MD, PE Abstract Falls are a high-volume, high-cost problem in he…

3331. Creating Safety in the Testing Process in Primary Care Offices (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Elder_18.pdf
      February 19, 2008 - Creating Safety in the Testing Process in Primary Care Offices Creating Safety in the Testing Process in Primary Care Offices Nancy C. Elder, MD, MSPH; Timothy R. McEwen; John M. Flach, PhD; Jennie J. Gallimore, PhD Abstract Background: The testing process in primary care is complex, and it varies from o…

3332. Emergency Nurses Association content and transcript (pdf file)
      www.ahrq.gov/sites/default/files/publications/files/ena-slides.pdf
      September 01, 2015 - Emergency Nurses Association content and transcript AHRQ Safety Program for Reducing CAUTI in Hospitals The Emergency Nurses Association Presents CAUTI Slides and Transcript AHRQ Pub No. 15-0073-5-EF September 2015 Contents Attribution......................................................................…

3333. Continuous Respiratory Monitoring and a “Smart” Infusion System Improve Safety of Patient-Controlled Analgesia in the Postoperative Period (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-Maddox_111.pdf
      June 18, 2008 - Continuous Respiratory Monitoring and a “Smart” Infusion System Improve Safety of Patient-Controlled Analgesia in the Postoperative Period Continuous Respiratory Monitoring and a “Smart” Infusion System Improve Safety of Patient-Controlled Analgesia in the Postoperative Period Ray R. Maddox, PharmD; Harold Oglesby…

3334. Imbedding Research in Practice to Improve Medication Safety (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-Raebel_53.pdf
      May 07, 2008 - Imbedding Research in Practice to Improve Medication Safety Imbedding Research in Practice to Improve Medication Safety Marsha A. Raebel, PharmD; Elizabeth A. Chester, PharmD; David W. Brand, MSPH; David J. Magid, MD, MPH Abstract Objective: The objective of this project was to improve medication saf…

3335. The Contribution of Diagnostic Errors to Maternal Morbidity and Mortality During and Immediately After Childbirth: State of the Science (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/reports/issue-briefs/dxsafety-issuebrief-maternal-morbidity.pdf
      September 01, 2021 - The Contribution of Diagnostic Errors to Maternal Morbidity and Mortality During and Immediately After Childbirth: State of the Science PATIENT SAFETY e Issue Brief 6 The Contribution of Diagnostic Errors to Maternal Morbidity and Mortality During and Immediately After Childbirth: State of the Science This…

3336. Fillmore (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/prevention-chronic-care/improve/system/pfcasestudies/fillmore.pdf
      August 01, 2014 - c Case Studies of EXEMPLARY PRIMARY CARE PRACTICE FACILITATION TRAINING PROGRAMS Agency for Healthcare Research and Quality Advancing Excellence in Health Care www.ahrq.gov The PCM Portfolio graphic element is intended to be closely aligned with AHRQ's overall brand, …

3337. Final Progress Report: Automated Lab Test Followup To Reduce Medical Errors (pdf file)
      www.ahrq.gov/sites/default/files/2025-03/greenes-report.pdf
      January 01, 2025 - Final Progress Report: Automated Lab Test Followup To Reduce Medical Errors Principal Investigator/Program Director (Last, first, middle): Greenes, David S. Automated Lab Test Follow-up to Reduce Medical Errors Principal Investigator: David S. Greenes, MD Department of Medicine, Children’s Hospital Boston Team …

3338. Final Progress Report: Are Volume Standards Accurate Measures? (pdf file)
      www.ahrq.gov/sites/default/files/2024-10/glance-report.pdf
      January 01, 2024 - Final Progress Report: Are Volume Standards Accurate Measures? FINAL PROGRESS REPORT: ARE VOLUME STANDARDS ACCURATE MEASURES? Principal Investigator: Laurent G. Glance, M.D. Co-Investigators: Andrew W. Dick, Ph.D. Turner M. Osler, M.D. Dana B. Mukamel, Ph.D. Organization: University of Rochester School of Medic…

3339. Final Progress Report: Oral Chemotherapy Safety in Ambulatory Oncology: A Proactive Risk Assessment (pdf file)
      www.ahrq.gov/sites/default/files/2024-01/weingart-report.pdf
      January 01, 2024 - Final Progress Report: Oral Chemotherapy Safety in Ambulatory Oncology: A Proactive Risk Assessment Final Progress Report 1.0 TITLE PAGE Oral Chemotherapy Safety in Ambulatory Oncology: A Proactive Risk Assessment Principal Investigator Saul N. Weingart, MD, PhD Co-Investigators Maureen Connor, RN, MPH Syl…

3340. Final Progress Report: Improving Safety and Quality with Outpatient Order Entry (pdf file)
      www.ahrq.gov/sites/default/files/2024-02/gandhi-report.pdf
      January 01, 2024 - Final Progress Report: Improving Safety and Quality with Outpatient Order Entry Grant Final Report Grant ID: 5R01HS015226-03 Improving Safety and Quality with Outpatient Order Entry Inclusive dates: 09/03/04 - 08/31/08 Principal Investigator: Tejal K. Gandhi, MD, MPH Team members: Eric G. Poon, MD, MPH Thomas D.…